Today 28 July 2018 is World Hepatitis day is being celebrated worldwide. The day was started by various European and Middle Eastern patient groups in order to spread awareness about disease and emphasize research on it. Initially it was declared by World Hepatitis Alliance  and patient groups on 19th May, 2008 however later on in 63rd World Health Assembly the date was changed to 28 July. The sole purpose to celebrate this day is to spread awareness to the world about different forms of hepatitis and how these are spreading, development and trial of vaccines against hepatitis B virus and emphasize the prevention, treatment and transmission control.
Each year this day is celebrated in many countries in order to spread awareness among people about infection control, strategies, free screening, poster shows, concerts, immunization and treatment regiments after infection. Every year it has a theme which is announced by WHO. This years theme for World Hepatitis Day 2018 is “Test. Treat. Hepatitis“.
Hepatitis is caused by many reasons including virus, bacteria, use of alcohol or toxic elements, autoimmune diseases etc but viral hepatitis is more prevalent with 96% of all hepatitis diseses and have become a real challenge for the health infrastructure.
According to WHO Hepatitis B and C are the major infections which have affected 325 million people worldwide, however these two kinds of infection are also chronic as symptoms are not seen while the infection in progress. An estimated 257 million persons worldwide are living with chronic hepatitis B virus (HBV) only [1]. The deaths caused by these two hepatitis types is about 1.3 million worldwide. Progression of hepatitis B and C leads towards hepatocellular carcinoma and cirrhosis of liver.
World Health Organisation (WHO) Efforts: On the day of World Hepatitis 2018 WHO has planned to arrange many events, the biggest event will be held in Mongolia where rate of hepatitis is very high. WHO has also established the Global Health Sector Strategy. This is the first global health sector strategy on viral hepatitis, a strategy that contributes to the achievement of the 2030 Agenda for Sustainable Development.

There are five types of hepatitis virus infections:

Hepatitis A: Hepatitis A is causes by HAV which is spread by fecal oral rout. This virus like other blood born viruses does not spread by blood but it spreads by ingestion of contaminated food with HAV. Although this virus is not dangerous as other viruses but can cause death by fulminant hepatitis where liver failure occurs. Its symptoms include fever, malaise, loss of appetite, diarrhea, nausea, abdominal discomfort, dark-colored urine and jaundice. Diagnosis of this virus is bases on the immunoglobulin G and M during the disease and after recovery.

Prevention from Hepatitis A: This virus infection can be avoided by taking following actions

  • Keeping good sanitary conditions around you.
  • Drinking potable water and eating safe food.
  • Taking care while handling an infected patient.
  • Getting immunized as Hepatitis A vaccine is available.
Hepatitis B: Hepatitis B virus is a real challenge and global burden for health. This virus is partially double stranded DNA virus. This viral disease is acute and chronic and causes hepatocellular carcinoma and cirrhosis. There are about 257 million people suffering worldwide with this infection.  The virus can be detected by Hepatitis B surface antigen (HBsAg), however its acute and chronic phases are distinguished by the presence of HBsAg plus immunoglobulin IgM in acute phase and presence of HBsAg more than six months in infected person in chronic phase.  The vaccine of this virus is available since 1986 and is effective in controlling the infection spread. Most of the people do not show any symptoms in acute phase of virus however some people show symptoms of yellowing of the skin and eyes (jaundice), dark urine, extreme fatigue, vomiting, nausea, and abdominal pain.

Preventive Measures:

  • Screening of all organs before transplantation
  • Screening of all kind of blood for those people who frequently require blood.
  • People who use drugs by injection should dispose off syringes.
  • Avoid household and sexual contacts with those people who have chronic HBV infection
  • Avoid sex with multiple partners
  • Avoid exposing to blood or patients skin abscesses as it contains virus
  • Vaccinate yourself before travelling to high risk countries
Hepatitis C: Hepatitis C is another infection causes by HCV which is a blood borne and spreads by a minute blood transfusion from infected person to healthy person. It is spread by infected syringes which are reused, razors reused by barbers, unsafe sexual intercourse etc. Like hepatitis B it is also an acute and chronic disease. According to WHO globally about 76 million people are having chronic hepatitis C virus. Symptoms if appear in this infection include fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, dark urine, grey-coloured faeces, joint pain and jaundice. Anti Hepatitis C virus antibodies in blood of patient is used in the diagnostic method.

Preventive Measures:

  • people who use intranasal drugs are at risk of developing HCV so avoid this practice.
  • use of safe blood and screening of blood before transfusion
  • people with sexual partners who are HCV-infected are at risk of HCV
  • avoid injecting drugs into skin with unsafe syring or reused syringes.
  • people with HIV infection can become HCV carrier too.
  • Piercing of skin, nose, ear should be avoided
  • avoid making tattoos on skins
Hepatitis D: This virus is not as dangerous as others because it is a satellite virus and can only cause infection with cooperation of HBV. It can cause infection and lead to liver fulminant. Hepatitis B virus patients are at high risk of developing with hepatitis D virus disease.
Hepatitis E: This virus can cause disease. It is a small virus, with a positive-sense, single-stranded ribonucleic acid (RNA) genome. HEV is like hepatitis A virus as it uses fecal oral rout to enter human body. It is found in contaminated water and poor quality food. However infection with this virus resolves automatically. Symptoms include fever, nausea, loss of appetite, abdominal pain, skin rashes etc

 

References: 
  • Department of HIV and Global Hepatitis Programme, World Health Organization, Geneva, Switzerland;  Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, CDC; Medicines Patent Pool, Geneva, Switzerland.
  • Razavi H, Waked I, Sarrazin C, Myers RP, Idilman R, Calinas F, et al. The present and future disease burden of hepatitis C virus (HCV) infection with today’s treatment paradigm. J Viral Hepat. 2014;21 Suppl 1:34–59.
  • European Association for the Study of the Liver. EASL Recommendations on Treatment of Hepatitis C 2018. Journal of hepatology. 2018. pmid:29650333.
  • http://www.who.int/hepatitis/strategy2016-2021/ghss-hep/en/
  • https://www.cdc.gov/mmwr/volumes/67/wr/mm6728a2.htm?s_cid=mm6728a2_w